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2016 ; 129
(9
): 1059-65
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gab.com Text
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English Wikipedia
Comparison of Talaromyces marneffei Infection in Human Immunodeficiency
Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian,
China
#MMPMID27098791
Li HR
; Cai SX
; Chen YS
; Yu ME
; Xu NL
; Xie BS
; Lin M
; Hu XL
Chin Med J (Engl)
2016[May]; 129
(9
): 1059-65
PMID27098791
show ga
BACKGROUND: Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic
human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an
opportunistic infection in patients with human immunodeficiency virus (HIV). The
objective of this study was to compare the clinical and laboratory parameters of
patients with TM infections who were HIV-positive and HIV-negative and to assess
therapies and outcomes. METHODS: This was a retrospective analysis of 26 patients
diagnosed with disseminated TM infection from September 2005 to April 2014 at
Fujian Provincial Hospital, China. RESULTS: Patients with TM infection tend to
present with fever, weight loss, and anemia. The time from symptom onset to
confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60
days, range: 14-365 days) than for HIV-positive patients (n = 19; median: 30
days, range: 3-90 days, Mann-Whitney U = 31.50, P= 0.041). HIV-negative patients
were more likely to have dyspnea (57.1% vs. 5.3%, ?2 = 8.86, P= 0.010), low
neutrophil count (Mann-Whitney U = 27.00, P= 0.029), high CD4 count (Mann-Whitney
U = 0.00, P= 0.009), and high lymphocyte count (Mann-Whitney U = 21.00, P=
0.009). There were no significant differences in other demographic, clinical, or
biochemical characteristics. Among all the patients, 12 HIV-positive patient and
1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom
improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses.
CONCLUSIONS: HIV-negative patients with TM infections tend to have a longer
diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and
lymphocytes, and lower neutrophil counts than TM infection in HIV-positive
patients. Treatment programs with amphotericin and fluconazole are mostly
effective.